Hip or knee replacement (inpatient stay)
Facility: Ochsner Medical Center Acute
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $104,507
- Cash Discount Price: $39,032
- vs. Medicare Baseline: 7.44x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $14,044.15 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 744% of the Medicare baseline (a markup of 644%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Christus Health Exchange Plan | $13,945 | 99% |
| UnitedHealthcare | $14,588 - $34,995 | 104% |
| American Health Advantage Of Louisiana (Formerly Dignity Health Plan) | $15,356 | 109% |
| Blue Cross Blue Shield | $15,356 - $33,618 | 109% |
| Healthy Blue Dual Advantage (Hmo-D-Snp) | $15,356 | 109% |
| Humana | $15,356 | 109% |
| Medicare (plans) | $15,356 | 109% |
| Ochsner Health Plan | $15,356 | 109% |
| Pace New Orleans | $16,892 | 120% |
| Medicaid / KanCare | $19,883 - $31,550 | 142% |
| Tricare | $19,959 | 142% |
| Cigna | $26,067 | 186% |
| Aetna | $26,966 - $29,312 | 192% |
| Louisiana Workers' Compensation Corporation (Lwcc) | $59,982 - $129,152 | 427% |
| Healthcomp & Personify Health (Formerly Gilsbar) | $64,453 - $138,780 | 459% |
| Mississippi Physicians Care Network | $81,793 - $176,116 | 582% |
| Employers Health Network (Ehn) | $92,699 - $199,599 | 660% |
| Prime Health Services Ppo | $92,699 - $199,599 | 660% |
| Usa Managed Care Network | $92,699 - $199,599 | 660% |
| Behavioral Health Systems | $98,152 - $211,340 | 699% |
| Evolutions Healthcare | $98,152 - $211,340 | 699% |
| Galaxy Health Network Ppo | $98,152 - $211,340 | 699% |
| Galaxy Health Network Wc | $98,152 - $211,340 | 699% |